硼中子捕獲治療(boron neutron capture therapy，BNCT) 是一用於治療癌症的粒子治療，具有高度的選擇性以及高效率殺傷能力，因此在有效殺死腫瘤細胞的同時，可同時有效減少對正常組織的損傷。在臺灣，硼中子捕獲治療作為恩慈療法對復發頭頸癌患者或是末期惡性腦癌患者進行治療，以延長患者壽命與改進病人生活品質已獲得很好的成果。臨床上，復發頭頸癌患者於硼中子捕獲治療後，復發狀況並非罕見，因此需要一個更新穎療法以增加腫瘤控制率。末期腦癌患者則是僅有一半的患者對於硼中子捕獲治療具有較好的治療效益，因此需要一新指標於治療前協助患者評估硼中子捕獲治療是否具有顯著的治療效益。髓質免疫制細胞(myeloid-derived suppressor cells，MDSCs) 是一異質細胞族群，主要由兩個亞群組合，分別為多核髓質免疫抑制細胞(polymorphonuclear MDSCs，PMN-MDSCs)以及單核髓質免疫抑制細胞(monocytic MDSCs，M-MDSCs)，其功能為抑制腫瘤微環境中之免疫反應。此研究透過一小鼠頭頸癌的臨床前模型評估硼中子捕獲治療合併標的髓質免疫抑制細胞之治療潛力，並分析臨床復發頭頸癌患者於治療前後之血液檢體中髓質免疫抑制細胞數量與腫瘤進展的關聯性。而對於惡性腦癌患者則分析治療前之各類參數，以期找出一合適的指標評估患者進行BNCT治療的效益。臨床前的動物研究顯示，硼中子捕獲治療合併標的髓質免疫抑制細胞，不僅可以有效延長癌鼠平均存活天數，同時也能夠抑制髓質免疫抑制細胞浸潤到腫瘤微環境並增加T細胞的浸潤，顯示此合併療法應用於臨床的可能性。另一方面，在臨床試驗中發現復發頭頸癌患者其循環髓質免疫抑制細胞比例與治療前以及治療後的腫瘤大小具有高度相關性，顯示髓質免疫抑制細胞可以作為此類患者於硼中子捕獲治療後治療反應的預後指標。此外在腦癌的臨床試驗中顯示硼中子捕獲治療能有效減輕末期惡性腦癌患者的腫瘤負荷、改善疾病控制並延長患者壽命，同時發現治療前的單核髓質免疫抑制細胞數量可用於評估患者進行BNCT治療效益的一合適生物指標。以上結果顯示髓質免疫抑制細胞可於腫瘤治療中作為腫瘤進展與治療標的以及用於評估硼中子捕獲治療預後之潛力。

Boron neutron capture therapy (BNCT) is a particle therapy for cancer treatment characterized by its high selectivity and destructive ability. This allows for effectively killing tumor cells while minimizing damage to surrounding healthy tissue. In Taiwan, BNCT is applied as a salvage therapy to extend patients' life of recurrent head and neck cancer or end-stage malignant brain tumors. Clinically, recurrence following BNCT is not uncommon in head and neck cancer patients, highlighting the need for novel therapies to improve tumor control rates further. For patients with end-stage brain cancer, only half respond effectively to BNCT, necessitating a reliable biomarker to evaluate the potential therapeutic benefits before treatment. Myeloid-derived suppressor cells (MDSCs) are a heterogeneous group of cells that suppress immune responses within the tumor microenvironment. These cells primarily comprise two subpopulations: polymorphonuclear MDSCs (PMN-MDSCs) and monocytic MDSCs (M-MDSCs). This study aimed to assess the therapeutic potential of targeting MDSCs in combination with BNCT through a mouse model of head and neck cancer. Additionally, blood samples from clinical patients with recurrent head and neck cancer were analyzed to examine the correlation between MDSCs and tumor progression before and after BNCT treatment. For end-stage brain cancer patients, various pretreatment parameters were analyzed to identify a suitable biomarker for predicting patient outcomes. The pre-clinical results demonstrated that combining BNCT with MDSCs targeting not only significantly prolonged the median survival of 4-NQO-induced oral cancer mice compared to the BNCT-alone group but also reduced MDSCs infiltration in the tumor microenvironment and increased T-cell infiltration, supporting the clinical potential of this combined therapy for head and neck cancers. The clinical study showed that the level of circulating MDSCs in recurrent head and neck cancer patients had a strong correlation with tumor size before and after treatment. In end-stage brain tumor patients, BNCT effectively reduced tumor burden, improved disease control, and prolonged survival. MDSCs could serve as a prognostic marker for evaluating therapeutic responses of BNCT in these end-stage brain tumor patients. These findings underscore the potential of MDSCs as both therapeutic targets and prognostic indicators in cancer progression, particularly in the context of BNCT.

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